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Perioperative Bleeding

Hemorrhage (bleeding) can be a problem in the immediate post-transplant period. Bleeding usually occurs from the pleural space between the lungs and the inner chest wall. Patients who need to be placed on a heart-lung machine during their transplant are more predisposed to bleeding since their blood is thinned. Patients with excessive scarring in the pleural space from prior chest surgery, infection or placement of chest tubes are also predisposed to bleeding.

Post-transplant bleeding is usually easy to diagnose since all patients have chest tubes draining the pleural space. Some bleeding is a normal result of surgery, but heavy bleeding may require intervention. Depending on a patient's situation, he or she may receive blood products or coagulants to slow the bleeding. In some cases the patient must be returned to surgery to find the source of the bleeding.

Patients may also develop bleeding in their gastrointestinal tracts, a fairly common occurrence with any major surgery. Most patients receive medication prior to surgery to lessen the chance of GI bleeding.